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Insights from the Cancer Control Field:
The Witness Project in Rochester

At a Glance

The Rochester Witness Project aims to increase awareness about the importance of early breast and cervical cancer screening and HPV vaccination for cervical cancer prevention. In addition, the Rochester Witness Project has expanded its reach to include a myriad of preventive care and wellness resources, such as transportation and food assistance. Read this case study narrative to learn how the Rochester Witness Project implemented the program and how it can be used in your setting.

Challenges and Lessons Learned

Sustaining the Program

The implementer shared that their biggest challenge to sustaining the program is funding. The majority of Rochester Witness Project funding came from private donors and grants. Most of this implementer’s funding comes from private donors and grants. The Rochester site has created a network to be proactive about finding grant opportunities.

The second biggest challenge is retaining volunteers who can commit to supporting the program for the long term. To keep volunteers engaged, the Rochester Witness Project team meets at least every other week, mostly in person but sometimes virtually.

Promoting the Program

The implementer had success promoting the program on a faith-based radio station and hosting a Q&A session at a popular beauty shop in the area.

Public Health Challenge

In 2020, approximately 15,500 new breast cancer cases and approximately 840 cases of cervical cancer were diagnosed. Nearly 250 women die from cervical cancer in New York each year. Black women have a higher rate of death from breast cancer and cervical cancer than do women from other racial/ethnic groups. Breast and cervical cancer screening programs are needed to improve access to screening and to detect breast and cervical cancer early.

It is recommended that women aged 50 to 74 get a mammogram every 2 years and women aged 40 to 49 talk to their health care provider about when and how often to get a mammogram. Breast cancer screening can help detect breast cancer early, when it is easier to treat. Human papillomavirus (HPV) and Pap tests can help prevent cervical cancer or detect it early. For women aged 21 to 29, cervical cancer screening with a Pap test is recommended every 3 years. For women aged 30 to 65, screening is recommended every 3 years with a Pap test, and every 5 years with high-risk HPV (hrHPV) testing or with hrHPV testing in combination with a Pap test (co-testing).

The Setting

The National Witness Project started in 1990 in Little Rock, Arkansas, and is a culturally informed, community-based breast and cervical cancer education program. It is designed to increase awareness, knowledge, and motivation, thereby increasing screening and early detection behaviors among African American women and ultimately reducing their morbidity and mortality from breast and cervical cancer. The Witness Project has been replicated nationally at more than 30 program sites in 22 states.

One of these replications is the Rochester Witness Project, which began in 2014. The program champion of this site was on the board of the First Ladies of Western New York, a group that works with the Western New York Witness Project. After hearing about the alarming mortality rate of Black women diagnosed with breast cancer, the champion saw a need for this program in her area, and she advocated for implementing The National Witness Project in Rochester. The Rochester Witness Project catchment area includes Monroe County and reaches about 2,000 people per year.

The Approach

The program relies on lay health advisors to deliver breast and cervical cancer education. While the original National Witness Project used cancer survivors as the health advisors, the Rochester location seeks volunteers from a network of local churches. Becoming a volunteer is not limited to just cancer survivors. Anyone dedicated to helping can volunteer.

At least twice a month, the Rochester Witness Project holds presentations at health fairs or at partner organization events. The organization also trains volunteers to give the presentations and sustain the cadence of these events. They hold approximately four panel discussions a year for the community. The presentations:

  • Bring awareness to the community about cancer prevalence and cancer screening options
  • Help identify screening barriers and new screening needs (e.g., transportation, insurance, new promotion of colorectal cancer screening)

The Rochester Witness Project implements routine surveys to assess the needs of participants. Surveys ask about health insurance status, transportation accessibility, and food insecurity. To reach people with differing levels of familiarity with technology, the Rochester Witness Project utilizes both phone and paper surveys. Survey data can be used to inform new areas of focus for awareness and outreach. A team of navigators connects those with needs (e.g., health insurance or transportation challenges) to the proper resources. As new needs are identified, the implementer makes changes to the program and finds assets in their community to provide the needed support. For example, another Witness Project site uses a mammography screening bus to address screening needs, and the Rochester program is working on bringing the bus to its local community to improve access to breast cancer screening.

We are able to increase screenings for cancer (breast, cervical, and colorectal) in our community by implementing the Witness Project.

—Rochester Witness Project Implementer

Questions and Answers

Do you have any specific strategies to recruit lay health advisors?

In Rochester, it has really helped to recruit volunteers with a passion for this type of work who can become champions for the cause. Providing a small stipend for volunteers can also help with recruitment.

Find Out More

View the program summary to learn more about the National Witness Project and how to use the program at your organization.


The Implementer

Charmaine Geeter
Rochester, NY

The Developer

Dee Johnson
National Witness Project